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F. RICHARD NOODLEMAN MD A PROFESSIONAL CORPORATION NPI 1710172994


NPI Information

NPI: 1710172994
Provider Name: F. RICHARD NOODLEMAN MD A PROFESSIONAL CORPORATION

Doing Business As: AGE DEFY DERMATOLOGY AND WELLNESS INCORPORATED

Classification: Dermatology - 207NS0135X
Entity Type: Organization

Specialization: Procedural Dermatology

Address:
3803 S BASCOM AVE
SUITE 200
CAMPBELL, CA
ZIP 95008
Phone: (408) 559-0988
Get Directions

F. RICHARD NOODLEMAN MD A PROFESSIONAL CORPORATION is a procedural dermatology dermatology in Campbell, CA. The provider is procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). F. RICHARD NOODLEMAN MD A PROFESSIONAL CORPORATION NPI is 1710172994. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Age Defy Dermatology And Wellness Incorporated.

The provider's business location address is:

3803 S BASCOM AVE
SUITE 200
CAMPBELL, CA
ZIP 95008-317
Phone: (408) 559-0988
Fax: (408) 369-4263

The provider's authorized official is Frank Richard Noodleman .
The authorized official title is Medical Director and has the following contact phone number (408) 559-0988.

The enumeration date for this NPI number is 9/11/2007 and was last updated on 10/24/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207NS0135XDermatologyProcedural DermatologyG422290CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1A48868MEDICARE UPINCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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